Table 3 Summary of the clinical and CT features of benign bladder lesions
From: Multidetector computed tomography evaluation of bladder lesions
Bladder lesion | Clinical features | CT features |
|---|---|---|
Leiomyoma |  < 0.5% among all types of bladder tumors Most common in those approximately 50 years of age Intravesical (60%, symptomatic), intramural (10%), or extravesical (30%) | Well-delineated, smooth, and uniform solid mass of the bladder wall Like those of uterine leiomyoma Cystic component indicating degeneration |
Papilloma and PUNLMP | Papillary lesions of the bladder urothelium PUNLMP: low-grade, small, solitary neoplasm with no invasion or metastasis Surveillance is required (recurrence and progression) | Polypoid enhancing lesion and filling defect Difficult to distinguish from low-grade carcinoma |
Cystitis Cystica and Cystitis Glandularis | Chronic inflammatory disorders Association with metaplasia incited by chronic irritation or infection Predominantly occur at the bladder neck and trigone | Single or multiple masses that are variable in number and size May result in a cobblestone pattern |
Endometriosis | Only premenopausal women Posterior wall of the bladder, including the dome, trigone, or vesicouterine pouch | Typically, a submucosal mass, located posteriorly in the bladder, obtuse bulge into the lumen Other endometriosis foci in the pelvis |
Paraganglioma | < 6% of all paragangliomas < 0.06% of all primary bladder tumors Most common in those aged 30–50 years, sporadic occurrence (mostly) Hereditary syndrome (neurofibromatosis, von Hippel–Lindau and Sturge–Weber syndrome) Characteristic ‘micturition attack’ Functional paraganglioma (> 3 cm) | Well-marginated, submucosal, solid solitary mass Most common in the dome or the trigone of the bladder Attach to the bladder wall with a broad base |
Inflammatory Myoblastic Tumor | Spectrum of nonneoplastic myofibroblastic proliferation with inflammatory infiltrates and myxoid components Younger individuals, particularly female patients Associated with a history of undergoing pelvic surgery | Single intraluminal or exophytic bladder mass May be ulcerated or show ring enhancement Superior wall or the front wall of the bladder |
Solitary Fibrous Tumor | More common in males Most common in those aged 42–67 years | Well-demarcated, solid, polypoid intraluminal or submucosal enhancing masses Presence of prominent feeding vessels or a vascular pedicle |
Acute Cystitis | More common in females Usually caused by Escherichia coli Diagnosed by history, clinical exam, and laboratory findings | Diffuse bladder wall thickening, mucosal irregularity, enhancement, and mural hypertrophy Sometimes a pseudotumor or focal protrusion Chronic state: bladder volume may be reduced due to fibrosis or contraction of the bladder wall |
Eosinophilic Cystitis | Rare chronic inflammatory disease of the bladder Extensive local infiltrate of eosinophils into all layers of the bladder wall | Nonspecific with focal or diffuse bladder wall thickening |